Moral Arguments for Universal Health Care
A Vision for Health Care Reform
by
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This book is about ethics and health care reform. More precisely, the author provides several arguments derived from a variety of ethical theories to support a unifying vision for reform of the American health care system. His vision is a health care system that achieves eight goals: Ensure equitable access and effective care; provide cost-efficient care and finance health care fairly; generate and sustain the resources required; protect participants' rights and ensure representation of everyone in the system; and finally, provide health care services responsive to the population's expectations and health care needs. These elements and norms constitute the author's definition of universal health care. A basic premise of the author's argument is that our health care debate is not solely about economic, political, medical, or legal issues; it is fundamentally a moral issue and reflects a persistent conflict of values. In other words, to achieve and sustain universal health care in America requires wider agreement about the kind of society we should be and ought to become. Health care reform is ultimately a matter of social ethics. A second premise of this book is that an ethical analysis should be an essential element in all phases of a policy cycle - problem identification policy formulation, implementation, and evaluation. Policy proposals should cite their guiding values and moral justifications.
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About the Book
Health care reform is always about more than morality and values, but if it lacks a moral foundation, it will not stand the test of time. Dr. Olson provides a moral foundation expressed in eight standards derived from his study of ethics, systems theory, and health policy research. From these normative standards he derives a vision of universal health care as both a public policy of protecting and promoting the health of an entire population, and a system for organizing, fi nancing, and delivering high quality care, which is affordable and accessible to everyone based on their need. Universal health care is fi nanced fairly to ensure sustainability through shared responsibility with personal choice of health care providers and/or health care plans. This unifying vision for health care reform is pluralistic with respect to the design of systems to implement it. The author provides several moral arguments from divergent ethical theories, which converge to support his vision of universal health care and its specifi c elements. In the process, he illustrates how to reason to moral conclusions based on clear thinking about both values and relevant facts. He also shows why and how ethical discourse is both relevant and necessary to the formulation, implementation, and evaluation of health care policy. Discussion of the controversy over medically necessary care and an ethical analysis of the Affordable Care Act are unique features of this book.
About the Author
R. Paul Olson earned his B.A. degree from Carleton College, an MDIV. degree from Yale Divinity School, and his Ph.D. in clinical psychology from the University of Illinois-Urbana. His perspective on health care reform derives from several years of clinical experience, teaching on professional ethics, and research on health care systems.